Bariatric Surgery: No Link to Reduced Healthcare Costs

Makes sense.

Bariatric surgery was not associated with lowered healthcare costs 3 years after the procedure in a population of older, mostly male patients, according to results from a study published in the July 16 issue of the Archives of Surgery.

The new results run counter to prior observational studies in which researchers saw a substantial drop in healthcare costs after bariatric surgery in primarily young, white, female patients.

As bariatric surgery has grown in popularity, the patient population has become more diverse. More nonwhite, male, and older patients, with more obesity-related comorbidities, are opting for these procedures. However, little is known about the effects bariatric surgery might have on future healthcare expenditures.

Therefore, Matthew L. Maciejewski, PhD, from the Center for Health Services Research in Primary Care, Durham Veterans Administration Medical Center, North Carolina, and colleagues conducted a retrospective cohort study that compared healthcare expenditures of 847 veterans 3 years pre- and postsurgery to expenditures among 847 propensity-matched veterans who did not have the surgery. Characteristics for matching included age, sex, race, marital status, and body mass index. All participants were from the same dozen Veterans Administration medical centers and were evaluated from 2000 to December 2006.

Healthcare costs included costs associated with the procedure and peaked for the surgical group around the time of the surgery. The investigators found that expenditures among the treated patients were $4397 higher in the first 6 months after surgery compared with the untreated group. However, the costs were similar between the 2 groups from 31 to 36 months after surgery. The researchers thus disproved their hypothesis that 3 years later the cohort that underwent surgery would have lower expenditures than the matched control patients.

The investigators attribute the lack of predicted savings to examining a different population than previous observational studies. The cohort of the current study was largely male and had more severe health problems than the previous studies, which included younger, mostly female patients.

No savings.

No payment from the public coffers.